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益生菌能提高生育结果吗?益生菌作为单一干预措施,改善非症状性育龄期妇女女性生殖道微生物群的能力。

Can probiotics enhance fertility outcome? Capacity of probiotics as a single intervention to improve the feminine genital tract microbiota in non-symptomatic reproductive-aged women.

机构信息

Ginefiv Clinic, Generalife, Madrid, Spain.

出版信息

Front Endocrinol (Lausanne). 2023 Jan 19;13:1081830. doi: 10.3389/fendo.2022.1081830. eCollection 2022.

Abstract

Modifications in vaginal and endometrial microbiome and microbiota have been associated with fewer implantation rates and poorest pregnancy outcomes. Therefore, its study has emerged as a new biomarker in reproductive medicine. Despite the numerous papers published on probiotic use for vaginal dysbiosis and their actual wide empiric use especially for infertile patients, there is still no clear answer to justify their recommendation. The impact of probiotics on the vaginal or endometrial microbiota has often been investigated under a symptomatic altered vaginal microbial ecosystem, such as bacterial vaginosis. However 50% of women with bacterial vaginosis are asymptomatic. Actual clinical practice guidelines clearly recommend the use of specific antimicrobial agents for the management of symptomatic vaginal infections. Assuming this should be the management as well for an infertile population, what should be the treatment for the 50% non-symptomatic women presenting unfavorable vaginal/endometrial microbiota? The aim of this review is to assess the capacity of probiotics as a single intervention to alter the feminine genital tract microbiota in non-symptomatic reproductive-aged women.

摘要

阴道和子宫内膜微生物组和菌群的改变与较低的着床率和最差的妊娠结局有关。因此,它的研究已经成为生殖医学的一个新的生物标志物。尽管有大量关于益生菌用于阴道菌群失调的研究,并在临床上广泛应用于不孕患者,但仍没有明确的答案来证明其推荐的合理性。益生菌对阴道或子宫内膜微生物群的影响通常在阴道微生物生态系统发生改变的症状下进行研究,例如细菌性阴道病。然而,50%的细菌性阴道病患者无症状。实际的临床实践指南明确建议使用特定的抗菌药物来管理有症状的阴道感染。假设这也应该是不孕人群的管理方法,那么对于 50%出现不良阴道/子宫内膜微生物群的无症状女性,应该如何治疗?本文的目的是评估益生菌作为单一干预措施,改变非症状性育龄期妇女生殖道微生物群的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b8a/9893107/cb20890f2501/fendo-13-1081830-g001.jpg

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